Considering revision from lapband to RNY - have questions

Hi everyone. I posted this on the RNY board, am also posting here.

I had my lap-band in July of 2008, and have lost 43 pounds since my surgery day, and 55 pounds since my pre-op appt. Some would consider that a success, but I am having "buyer's remorse" so to speak, and am considering revision to RNY. I still have over 90 pounds to lose.

In November, the Monday before Thanksgiving, I was experiencing incredible pain and could not keep anything down. I ended up having emergency surgery because my band had slipped. I don't ever want to experience that kind of pain again! Now I'm back at square one, with very little restriction and the ability to eat anything. I don't feel like I should have to "diet" until I have good restriction. Prior to my emergency surgery, I had very good restriction, almost too good. Sometimes food got stuck in my chest, which was incredibly painful. Or, I would experience the foaming or sliming that people talk about. So here are my questions about RNY:

1) With RNY, does food ever get "stuck" in your chest, causing discomfort, if you take too big of a bite or eat too fast?

2) Do you have to chew chew chew your food forever like you do with the band?

3) Do you ever experience foaming and or sliming?

4) Can you ever eat bread/pasta/pizza again? Or are those foods forever off your menu?

The surgeon who fixed my slipped band is not the same surgeon who did my lap band, I switched when the hospital I went to closed their bariatric unit. I love my new surgeon! He is definitely supportive of RNY, and I believe that if I had gone to him originally, I would never have gotten the band, he would probably have recommended RNY. He has told me that he is happy to start the approval process with my insurance company in order to do a revision to RNY, and tells me that I would do great with it.

Any suggestions or comments you have would be helpful. Thanks!

Hi, Pam.

I'm sorry your Lap Band isn't performing as expected. Have you considered a revision to a DS? I ask, because your questions lead me to believe that you might want to.

I can't answer the questions for the RNY, but I've been doing enough reading about the DS to tell you that

1. Food doesn't get "stuck," because you retain the normal anatomy of a normal stomach. It's smaller than a normal stomach, yes, but food moves through the stomach normally.

2. DSers don't need to chew their food to liquid, because they don't have a pouch, they have a normal (though smaller) stomach with a normal pyloric valve.

3. No foaming or sliming with the DS (no sugar dumping, either)

4. Carbs during the first 12-18 months will definitely slow your weight loss, but once you're at goal, you can begin introducing the carbs back into your daily food intake.

Come over to the Duodenal Switch message board. The folks there are very happy to answer any of your questions.

BTW.... I had a Vertical Banded Gastroplasty 22 years ago, and have lived with Lap-Band type issues ever since ... vomiting, food getting stuck, sliming, etc. I'm preparing for a revision to a DS. I'm tired of living with a pouch. Sounds like you might be tired of it, too.

The best of luck in whatever you choose, Pam

Kathy

everything that Kathy said about the DS is true..I would just like to add that you might want to go to have a consult with a surgeon who does revisions to the DS (there are not a lot out there, but you will get a  objective information and support from someone who des the surgery) It's always good to explore all of your options and make a fully informed decision.

a good website is www.dsfacts.com/

Good luck
in your search


Jacqui

1.  RNY People have the same requirement to chew their food excessively and unnaturally just as bandsters do.   For the RNY folks it may be even more imperative they do so.  They have a stoma - an artificial opening where the newly created false stomach empties into the intestines.  It is very small and large food will get stuck and have to be dislodged - usually by vomiting or swallowing a mixture of warm water and meat tenderizer.   If you can nont dislodge it, surgery may be required.

2. Yes, Yes, Yes

3. You throw up with RNY whenever you dont chew like you did with the band.  Also, if you eat the wrong type of foods, you may dump - a very nasty experience triggered by wild swings in blood sugar, heart racing, nasuea, tiredness and more.

4. Since carbhohydrates can lead to dumping it is hard to say.   The false stomach of an RNY person does strech.  As you get further out you may have pasta, but you also have a much greater chance of regain.

I strongly urge you to consider a DS.  The answers to your question for a DS are as follows:

1. You have a fully functioning, albeit smaller stomach.  It functions much like a normal stomach only a bit smaller.  It will grow over time and hold maybe half of what you did pre-op.   There is no stoma, so you do not have to worry about strictures or things getting stuck.

2. No, NO, NO

3. Immediately post op, if you overfill your new stomach, you can get sick.  I found once I healed that this stopped. 

4. Carbs are a problem in that they may slow weight loss.   With a DS they can also give some people gas, so you wil have to judge for yourself.   Plenty of us eat these things just fine in moderation.   Dreamfileds pasta has been altered to reduce this impact and tastes just like regular pasta.

You would really do well to check into the Duodenal Switch.    It has the best results with respect to Excess Weight Loss both in the short and long term.   You will not be worried about dumping, marginal ulcers or strictures.   The DS is also vastly superior in reducing comorbid conditions. 

I give you  the following links to consider in addition to what information is on this site.   Also talk to the folks here on the DS board.

http://www.duodenalswitch.com/
http://www.dsfacts.com/

I had a lapband and was miserable.  It failed for me too.  I had to have my revision done in 2 parts due to the difficulty of removing the band.   You have already had that done.  I suggest you find a good DS surgeon to discuss this with.   Use the lists on the websites I provided.  Do not use OH.com's list.  It is not reliable enough.

Peace,

William
 

Pam, I  did have the RnY and lost 90 pounds in the first 8 months. Then I was on a stall for almost a year and then started gaining and have gained 50 pounds back. It is a fact (though most RnY docs will not admit it), but an awful lot of RnYers do gain weight back. It is certainly no picnic. The problem is you just ddon't know if you will be one of the ones who does gain weight back. I call it a "crapshoot" as you just don't know if you will do well, and many do, or who will have problems. Then if you have a RnY problem, you will be looking for something else, and that is the DS, the only one left that insurance will cover as of right now. Why not check out the DS for yourself before you make the final decision to have RnY. We just don't want you to be sorry you chose the wrong rrevision. I just did not know about the DS before I had my RnY and we are just trying to let you know there is another option out there. Do well my friend.

                                              

                                                     

Pam, I'm totally for revisions - especially to the DS when necessary,  BUT first give your Band a chance.  I had many bumps (surgeon abandonment, flipped port right out the door, cracked port & hosing after doc kept jabbing me.  obstruction for 8 days with no medical care.  dialated esphogas, reflux, night cough,  I almost NEVER got restriction and when I did, it wasn't without "issues" .  My success with the band came in year #3.  It may be that I decided this has to work or I am truly going to revise???  It may be some miracle???  It may be that I've committed to Weigh****chers for an entire year and have to be accountable???  It may be that I have the best surgeon in the world ??? I don't know what it is, why my band is working now, BUT it is and I'll take it.

Believe in your Band - think it is going to work.  NEVER keep a too tight band or IT WILL SLIP AGAIN or you'll have other complications- Believe that!!!

. . . . . . .  and if after believing and doing the best you can to work with your band and it just doesn't work  consider revising.  Sometimes (not all the time) after a slip, the band is never the same.

Good Luck to you Pam.

(((HUGS)))
Leila